Faulkton Area Medical Center
1300 Oak Street Post Office Box 100, Faulkton, SD 57438 · 87 Priced Procedures
Typical commercial prices here match the fair market benchmark (0.98×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Aligned Regional Benchmark Peer
Faulkton Area Medical Center prices shoppable and inpatient services (0.8× to 1.0× Medicare, divergence 1.25×) in alignment with regional hospital peers (0.98× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 2% below peer Fair BaseRate (0.98×)
- Self-pay cash beats commercial insurance on 67% of shoppable procedures (51/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (93.5% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.98× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Captive ER (0.6×) & laboratory (0.5×) services average 1.25× higher multiples than routine shoppable care (0.8×)
- Even at low-cost facilities (0.98× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Unnegotiated chargemaster list prices average 11.0× Medicare (27¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Faulkton Area Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 87 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,274 | 10.3× |
| MRI, lower back (no contrast) CPT Code: 72148 | $4,566 | 13.5× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,266 | 9.5× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $4,153 | 4.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $4,047 | 13.4× |
| MRI, knee or other leg joint CPT Code: 73721 | $3,955 | 10.7× |
| CT scan, chest (no contrast) CPT Code: 71250 | $3,812 | 22.8× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $3,494 | 13.5× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,632 | 15.7× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,632 | 15.6× |
| CT scan, pelvis CPT Code: 72192 | $2,479 | 15.2× |
| MRI, brain (no contrast) CPT Code: 70551 | $2,472 | 7.2× |
| CT scan, head (with contrast) CPT Code: 70460 | $2,349 | 9.7× |
| CT scan, sinuses CPT Code: 70486 | $2,263 | 13.6× |
| CT scan, head (no contrast) CPT Code: 70450 | $2,210 | 13.8× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $2,031 | 15.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,473 | 2.5× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $1,245 | 9.9× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $1,096 | 8.3× |
| Blood transfusion CPT Code: 36430 | $939 | 1.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $897 | 3.3× |
| Ultrasound, pelvis CPT Code: 76856 | $869 | 6.7× |
| Colonoscopy with biopsy CPT Code: 45380 | $681 | 0.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $624 | 0.6× |
| X-ray, lower back CPT Code: 72110 | $575 | 5.1× |
Audit a Bill or Quote at Faulkton Area Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $6,161
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (93.5% of gross = $6,161).
Self-Pay Cash Rate ($5,274) Beats Your Bill
Faulkton Area Medical Center's published 45 CFR § 180 self-pay cash rate is $5,274 (vs. $5,274 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $511 Fair BaseRate ($356 Medicare)
Your bill ($6,592) is $6,081 above the denoised Fair BaseRate ($511) and 18.5× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (93.5% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Faulkton Area Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.